Radiation-induced tumors in irradiated stage I testicular seminoma: results of a 25-year follow-up (1968-1993).
OBJECTIVE
Testicular seminoma is a very radiosensitive and curable cancer, with survival rates following radiation therapy within the range of 90-98% without apparent severe side effects. However, long-term survival following exposure to moderate-dose radiation therapy can result in radiation-induced tumors.


METHODS
The incidence of radiation-induced tumors was determined in 81 irradiated stage I testicular seminoma patients treated at the Northern Israel Oncology Center (NIOC) from 1968 through 1993.


RESULTS
Three (4%) patients developed second cancers within the high-dose volume. Indeed, those patients received a higher than usual dose to the para-aortic and pelvic regions. One patient, who developed inoperable pancreatic carcinoma, was treated with "hockey stick" field and mediastinal irradiation, plus, as a result of relapses, multiple cisplatin and VP-16 based regimens.


CONCLUSIONS
The elimination of causative factors through lower total doses and field size reduction may reduce the, albeit very low, incidence of radiation-induced cancer in cured testicular seminoma.
Stein
M E
ME
Northern Israel Oncology Center, Rambam Medical Center, Haifa, Israel. m_stein@rambam.health.gov.il
Leviov
M
M
Drumea
K
K
Moshkovitz
B
B
Nativ
O
O
Milstein
D
D
Sabo
E
E
Kuten
A
A
D000230:Adenocarcinoma / Q000209:etiology*; D002295:Carcinoma, Transitional Cell / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009381:Neoplasms, Radiation-Induced; D010190:Pancreatic Neoplasms / Q000209:etiology*; D011879:Radiotherapy Dosage; D018239:Seminoma / Q000532:radiotherapy*; D012811:Sigmoid Neoplasms / Q000209:etiology*; D013736:Testicular Neoplasms / Q000532:radiotherapy*; D001749:Urinary Bladder Neoplasms / Q000209:etiology*